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1/253. latex allergy in an orthognathic patient and implications for clinical management.

    A 19-year-old girl with mild asthma had had 16 months of orthodontic treatment as part of the joint orthodontic/orthognathic approach to her 9.5 mm overjet. At the time of banding her second molars she developed latex protein allergy as a reaction to the operator's non-sterile powdered latex gloves. She also gave a history of allergy to other substances as well as of eczema. The patient was confirmed as allergic to latex protein by radioallergosorbent test (RAST) for IgE, requiring precautions be taken during further orthodontic procedures as well as during the subsequent orthognathic surgery for the underlying Class II skeletal pattern. ( info)

2/253. Design and fabrication of a modified protraction headgear for Class III long face patients.

    Treatment of children with long face and with Class III malocclusions is difficult because most of the available appliances treat one of the two problems at the cost of aggravating the other one. In this article, we present the steps of design and fabrication of a modified protraction headgear that can be useful for such a patient. A patient treated with this approach is presented. ( info)

3/253. Multilingual bracket treatment combined with orthognathic surgery in a skeletal class III patient with facial asymmetry.

    A case report is presented on a female adult with a Class III mandibular protrusion. Resolution of her dentoskeletal problem required a combination of comprehensive multibonded orthodontic mechanotherapy and orthognathic surgery. The patient preferred a multilingual bracket appliance because of esthetics. Both surgical and orthodontic treatment were quite successful in the correction of the facial profile and occlusion. Both psychological and esthetic satisfaction were achieved. ( info)

4/253. Orthodontic correction of a class III malocclusion in an adolescent patient with a bonded RPE and protraction face mask.

    A case report of a 14-year-old Hispanic male with a Class-III skeletal profile and dental malocclusion with a long mandibular body and ramus and retrusive maxilla. The patient was initially referred for a surgical evaluation for a LeFort I maxillary advancement, but he wanted to avoid surgery. The Class-III malocclusion was corrected with a bonded rapid palatal expander and a maxillary protraction mask followed by nonextraction orthodontic treatment. A Class-I molar and canine relationship was achieved, and the facial profile improved. This case report demonstrates the orthodontic correction of a Class-III malocclusion in an adolescent patient with a bonded rapid palatal expander and protraction face mask. This case was presented to American Board of orthodontics as partial fulfillment of the requirements for the certification process conducted by the Board. ( info)

5/253. Molarization of the lower second premolars.

    This paper presents a case of extreme tooth variation. The patient was first observed during the mixed dentition period, when she presented a mild Class II malocclusion with increased overjet and acceptable overbite. In a panoramic radiograph, the presence of lower second premolars of disproportionate dimensions was discovered. When these oversized premolars erupted, the Class I malocclusion tended toward Class III, with an edge-to-edge bite. This created an unstable occlusion and the possible need for extractions. ( info)

6/253. Biomechanical considerations in distraction of the osteotomized dentomaxillary complex.

    The completely osteotomized dentomaxillary complex is essentially a free body constrained only by its soft tissue attachments. Therefore the line of action and point of application of any protractive force(s) used during distraction osteogenesis must be considered relative to its center of mass. This is in contrast to the nonsurgically separated dentomaxillary complex, which is a constrained body, and therefore the application of protractive force(s) must be considered relative to its center of resistance. These two centers are not coincident. With knowledge of the location of the center of mass, predictable protraction of the dentomaxillary complex can be achieved. In this study, the center of mass of an adult maxillary specimen osteotomized to emulate a Le Fort I osteotomy was determined. Protractive force(s) through the center of mass will produce linear advancement along its line of action. Protractive movement of the dentomaxillary complex can be adjusted downward and forward or upward and forward by locating the protractive force(s) line of action superior or inferior to the center of mass. A cleft patient is described wherein the surgically separated dentomaxillary complex is protracted downward and forward with a force vector superior to its approximate center of mass. This results in a predictable increase in overbite and overjet with negligible mandibular rotation. ( info)

7/253. Treatment of a Class III malocclusion with maxillary constriction and an anterior functional shift.

    This case was chosen by the CDABO student case selection committee for publication in the AJO/DO. ( info)

8/253. Implant anchorage for the occlusal management of developmental defects in children: a preliminary report.

    Congenital anomalies and developmental defects of the face and jaws often present orthodontic anchorage challenges in which the residual dentition cannot be adequately positioned for restorative objectives. This article presents a method of classification for the formulation of implant-based treatment protocols in children, reviews the application of implants in the developing dentition, and provides guidelines for occlusal treatment. Procedures performed according to the protocols outlined in this article will facilitate orthodontics and orthopedic movement and accelerate three-dimensional jaw movement by sutural distraction of basal bone. ( info)

9/253. An unusual treatment with sagittal split osteotomy: report of a case involving an odontoma.

    Sagittal split osteotomy is one of the most commonly performed surgical techniques in the world and has been modified by many authors. The efficacy of this operation has been studied by many groups. When performing this surgery, there should be adequate contact of wide, cancellous bone surfaces, which guarantees excellent and rapid bony union in the desired position. In the present article, treatment of mandibular prognathism with open bite by sagittal split osteotomy with an odontoma in the third molar area is presented. ( info)

10/253. Geometric considerations when planning an asymmetric genioplasty.

    The sliding osteotomy of the inferior border of the mandible, otherwise known as genioplasty, has often been described in the world literature with regard to diagnosis and treatment planning. However, the treatment of the asymmetric chin has received little attention. Moreover, diagnosis and treatment planning of asymmetric chins with concomitant orthognathic surgery is completely lacking from the literature. The complexity of surgically correcting asymmetric chins, compounded with complex, bimaxillary orthognathic surgery, is an extremely challenging task. This article looks at geometric considerations when planning the surgical correction of an asymmetric chin following a protocol of data collection, model surgery, diagnosis, and treatment planning. Clinical experience in the form of a case presentation will demonstrate the millimetric precision that can be achieved when planning corrective genioplasty in an asymmetric patient undergoing concomitant orthognathic surgery. ( info)
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